SUNDAY STAR, 18 OCTOBER 2020

OBESITY AWARENESS

Ray of hope for obese patients

THERE are times when obese
patients may feel hopeless during
their weight loss journey. No
matter how much they try to If patients feel like they
control their daily food intake and
exercise level to lose some pounds,
need to do something
it is just not enough sometimes. with their weight
Certain health conditions may also
be a factor that prevents an
problem, they should
overweight individual from not hesitate to consult
shedding some pounds.
Because excessive weight gain
a specialist.
and obesity can lead to a myriad of
health complications, medical
treatments may be the way to go that laparoscopic sleeve
for such individuals. Fortunately, gastrectomy is the most common
Subang Jaya Medical Centre surgery chosen by patients with
consultant bariatric surgeon Dr obesity around the world, as more
Cha Kar Huei explains that there than 50% of obese patients would
are quite a few treatments for undergo this surgery. “We remove Dr Cha Kar Huei.
obesity nowadays which are less about 70% to 80% of the stomach
invasive compared to ones a and leave the patient with a Cha says the most difficult part
decade ago. “Open surgery is rarely stomach about the size of a would be the post-surgery diet.
the option anymore when these banana.” Dr Cha explains that “Right after surgery, you have to
less invasive treatments are patients who undergo this surgery be on a liquid diet for one week.
available,” he says. will not be able to eat as much as The second week is like a puree
they are used to. This will help to diet and blended diet. The third
Many patients would worry about the recovery process after receiving
Straightforward change the patients’ eating habits
so that they will learn to eat better treatment, and Dr Cha says the most difficult part would be the post-
and fourth weeks are soft food
like porridge,” he says. In terms
procedures and slower. surgery diet. of other diets, a nutritionist will
Laparoscopic Roux-en-Y gastric be standing by to recommend the
Dr Cha classifies the minimally bypass and laparoscopic mini difficult. “To gain access to the last for 30 minutes.” Laparoscopic appropriate food intakes. Post-
invasive treatments into two gastric bypass are two popular abdomen, you’ve got to cut through surgery can take around one-and- operative pain is normally not an
categories – endoscopic and treatments among patients. some layers of fat and skin. So, that a-half hours to three hours, issue for patients, and patient are
laparoscopic. Endoscopy treatment Commonly known as a gastric is the advantage with the keyhole depending on the type of surgery. encouraged to ambulate early
is performed via the use of a thin, bypass, a small section from the surgery – you can see better.” Dr after surgery.
flexible tube with a monitoring
device attached at its end, while
stomach is isolated and this smaller
portion is connected to the small
Cha says these treatments reduce
the chances of bleeding, decrease
Minimal risks As for exercising, patients should
be able to get back on track after a
laparoscopy involves making intestine which has been rerouted. wound and lung infection rates, Dr Cha notes that patients who month – though they may still
multiple small incisions at the Dr Cha clarifies that while both the lessen post-operation pain and undergo these treatments usually suffer from mild abdomen
abdomen so that a small telescope sleeve and gastric bypass aid in shorten the length of patients’ do experience some side effects. discomfort then. Dr Cha also
can be inserted through one of the weight loss, “gastric bypass has an hospital stay. Almost every weight “Feeling bloated, nausea or stresses that a support group is
incisions to get a good view inside added advantage because by doing loss surgery in the world right now vomiting during the first four days vital for patients because it would
the abdominal area. a bypass to the small intestine, it is done via keyhole surgery. after the insertion of the balloon provide them mutual support in
The most popular endoscopic eventually changes the hormonal It is natural for anyone are normal. Patients can also easily dealing with the sudden changes to
treatment is the use of a gastric production of the small intestine”. considering undergoing this get dehydrated.” He mentions that their diet.
balloon, where a balloon is The bypass will cause the surgery to worry about its risks there are patients who require The other common question
inserted through the mouth with a production of hormones that are and complications, especially those some intravenous fluid asked by patients is whether they
scope and inflated in the stomach beneficial in controlling the with underlying conditions. replacement after the gastric would gain their previous weight
to a certain size. There is no patient’s blood sugar, such as However, Dr Cha assures that these balloon placement because of back. Dr Cha explains that weight
incision needed in this case. The glucagon-like peptide-1. As an treatments are safe for obese dehydration. In terms of loss with the gastric balloon is not
balloon will then reduce the space example, this hormone would patients. “Patients with diabetes complications of the gastric as sustainable as the surgery and
that is available for food. “This benefit diabetic patients in terms and high blood pressure itself is balloon, Dr Cha says gastric ulcers, only acts as a temporary fix. “The
balloon will help patients to cut of reducing blood sugar and not a contraindication for the bleeding because of gastric ulcers patient would gain some weight
down their appetite and that is insulin resistance. surgery. In fact, it would help them or any perforations of the stomach back after the removal of the
how they can reduce their weight,” – even those with significant heart are rare. balloon. That is why lifestyle
explains Dr Cha. This easily
adjustable gastric balloon can be
Changing trends history.” Nevertheless, if the
patient has had severe heart
For laparoscopic weight loss
surgery, leakage from the staple
changes is important.”
Dr Cha adds that he only offers
adjusted every few months and When asked how these failure and cannot withstand line or anastomosis (connection) the balloon treatment for those
must be retrieved one year after treatments differ from traditional general anaesthetic, the attending leaks are a major complication. A who do not need to lose a lot of
the insertion. bariatric surgery, Dr Cha explains physician would be very careful in leak may result in the need for weight. Surgery, on the other hand,
For laparoscopy – also known as that performing open surgery on terms of recommending the more surgeries, revisions and is different since it is more
keyhole surgery – Dr Cha mentions an obese patient can be quite surgery to them. prolonged hospitalisation with permanent. Weight loss surgery
As these treatments are rehabilitation. However, the risk of would usually be offered to those
minimally invasive, the time taken developing a leak is approximately with a body mass index of more
to complete the procedure can be between 0.5% and 1%. than 30.
very quick compared to traditional Quite a lot of patients would Finally, Dr Cha says the
bariatric surgery. “With a gastric worry about the recovery process treatments for obesity nowadays
balloon, the procedure will only after receiving treatment, and Dr are very straightforward and much
safer compared to open surgery in
the past, and that they are even
General surgical risks and possible side effects safer than emergency gall bladder
surgery. “If patients feel like they
Weight loss surgery, as with l Nausea, vomiting need to do something with their
any other major surgery, has l Gas, bloating weight problem, they should not
risks which patients should be l Lactose intolerance hesitate to consult a specialist.
aware of. l Changes in bowel habits While doctors may offer various
Although surgical types of weight loss procedures,
complications are infrequent, it is Potential complications and whatever the procedure that
important for them to fully include, but are not limited to: patients end up choosing, the
understand any potential risks so l Infection, bleeding or leaking single most important thing is that
that they can make an informed l Dehydration the patients will have to change
decision. l Blockage of the intestines or their lifestyles.”
Because excessive weight gain and obesity can lead to a myriad of health Potential side effects include, stomach pouch
complications, medical treatments may be the way to go for such but are not limited to: l Protein malnutrition n For more information, call
individuals. 03-5639 1212.
8 Obesity Awareness SUNDAY STAR, 18 OCTOBER 2020

Introducing online solutions

THE issue of obesity is nothing new in
Malaysia, with the nation holding the
lamentable position of having the highest
rate of obesity among Asian countries. Users can seek quick
Globally, obesity has been a public health
concern of the World Health Organization
consultations, should they
(WHO) since 1975. suspect themselves of
In Malaysia itself, obesity is recognised as
one of the leading risk factors contributing to
possessing any Covid-19
the rise of non-communicable diseases symptoms. Doctors
which, according to the WHO, causes up to
71% of deaths globally.
can screen the affected
This concern is further intensified with patients swiftly and
evidence from multiple studies – among
which are two research articles published
appropriate measures can
this year titled Individuals with obesity and be implemented to limit any
Covid-19: A global perspective on the
epidemiology and biological relationships
further contamination.
and Prevalence of obesity among adult
inpatients with Covid-19 in France –
indicating that obesity increases the risk with over 5,000 stock keeping units
and severity of Covid-19. 4) Tele-Consult: Professional consultations
Joining ongoing obesity and mental from the comfort of home. Tele-Consult
health awareness campaigns, BookDoc is brings healthcare to users’ fingertips through
highlighting two of its features – namely, a live chat session with healthcare
Digital Health coaching by in-house health practitioners and specialists covering topics
coaches who provide personalised advice Health director-general Tan Sri Dr Noor Hisham Abdullah (third from left) and BookDoc including children, skin, mental, women’s
on nutrition and exercises to ensure that founder Datuk Chevy Beh (fourth from left) commemorating BookDoc’s collaboration with and sexual health.
people stay fit and physically healthy; and the Ministry of Health Malaysia in April this year. 5) Events & News: The latest medical and
Mental Health consultations by mental health information are made available here,
health professionals via the BookDoc Tele- BookDoc is a multi-award-winning 1) Search & Book: A fast and hassle-free along with events such as health
Consult to address any significant and company that has won recognition from online appointment system with healthcare conferences, marathons, blood donation
sustained rise in mental health issues. CNBC, the ASEAN Summit and Frost & professionals to help facilitate physical drives and so on
For users who are hesitant to reach out or Sullivan (2015-2019) as one of the most distancing 6) Health Coaching: With this feature,
value their privacy highly, a Mental Health innovative healthcare technology start-ups 2) Activ: The higher the step count, the users will be able to reach out to its team of
consultation can be obtained anonymously in the region and globally. With a presence greater the rewards. By exercising, users in-house nutritionists and dietitians about
from the app. In addition, users can seek in five countries (Malaysia, Singapore, can earn rewards and discounts from over dietary advice to achieve their desired goals
quick consultations, should they suspect Indonesia, Hong Kong and Thailand) and 20 100 major retail partners in 12 countries 7) Covid-19 Feature: Users can make use
themselves of possessing any Covid-19 cities, BookDoc is an online platform that (redeemable across over 4,400 offline and of its lab uberisation of real-time Covid-19
symptoms. Doctors can screen the affected operates across the healthcare continuum, online locations). PCR tests and webinar sessions on Covid-19-
patients swiftly and appropriate measures connecting patients to healthcare 3) Marketplace: A premium e-commerce related matters, among others
can be implemented to limit any further professionals anytime and anywhere. platform with a variety of health services
contamination. The BookDoc app also BookDoc’s end-to-end healthcare available which users can enjoy at n For more information, download the
enables physical distancing for those looking ecosystem comprises seven comprehensive discounted rates and redeem at hospitals, BookDoc app at the Google Play Store or
to have any type of health consultations. platforms benefiting all users: clinics and other health/wellness facilities Apple App Store, or visit www.bookdoc.com
SUNDAY STAR, 18 OCTOBER 2020 9
10 Obesity Awareness SUNDAY STAR, 18 OCTOBER 2020

Customise weight loss

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IT is important to be fit and healthy making it safe for consumption. Total Image’s range of slimming

Obesity
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butt of jokes in mainstream media, > TURN TO PAGE 12 weight while nourishing the body,
SUNDAY STAR, 18 OCTOBER 2020 Obesity Awareness 11

Natural way to maintain

a healthy cholesterol level
IN recent years, the incidences of non- be oblivious to the truth and continue to absorption – it uses cholesterol in the
communicable diseases (NCDs) such as indulge in unhealthy lifestyles. bloodstream to do so. This results in a
heart disease have been on the rise in A slight modification in an individual’s reduction of one’s low-density lipoprotein
Malaysia, according to the 2019 National daily diet with the inclusion of high fibre cholesterol (bad cholesterol) level. A slight modification in an
Health and Morbidity Survey by the foods such as oat bran – which contains
individual’s daily diet with
Ministry of Health Malaysia. NCDs are diet-
related chronic diseases and the dominant
the cholesterol-lowering substance called
“oat beta-glucan” – is one of the most
Two-in-one health benefits the inclusion of high fibre
risk factors are a high blood cholesterol
level, diabetes, hypertension and obesity.
natural ways of managing a high blood
cholesterol level.
The Biogrow Oat BG22 oat bran powder
presents two-in-one health benefits in a
foods such as oat bran is
The aforementioned survey noted that eight Oat beta-glucan is a soluble form of much smaller and easy-to-consume serving one of the most natural ways
million Malaysians have a high cholesterol
level, 3.9 million Malaysians have diabetes,
dietary fibre that produces a cholesterol-
lowering effect due to its high viscosity. It
size. Some of the advantages of Biogrow Oat
BG22 include:
of managing a high blood
6.4 million Malaysians are afflicted with dissolves inside the digestive tract where it l Provides 3g of bioactive oat beta-glucan cholesterol level.
hypertension and 3.7 million Malaysians forms a thick gel in the small intestine. This with just two scoops/sachets (approximately
are obese. viscous ‘net’ traps cholesterol and 18g) of oat bran powder. Bioactive oat beta-
It is estimated that the prevalence of cholesterol-related particles (bile acids) and glucan is high in molecular weight and has oats and barley and maintenance of normal
these NCD risk factors will continue to prevents them from being absorbed into the been scientifically shown to produce good blood LDL-cholesterol concentrations,
increase and is indeed a worrying trend for bloodstream. They are then passed, viscosity effects in the gut for optimal increase in satiety leading to a reduction in
the country because many people seem to harmlessly, out of the body. When the liver cholesterol-lowering results, according to the energy intake, reduction of post-prandial
subsequently has to produce more bile acids Scientific Opinion on the substantiation of glycaemic responses and “digestive function”
– which are needed by the body for fat health claims related to beta-glucans from pursuant to Article 13(1) of Regulation (EC)
No 1924/2006 in the EFSA Journal.
l Lower in calories, higher in total fibre
Approved health claims: and lactose-free
l Contains no added sugar, artificial
The health claims for oat beta-glucan additives or preservatives
that are approved by the European Food
Safety Authority and the Ministry of Taking Biogrow Oat BG22 is a natural
Health Malaysia are as follows: way to obtain the highly bioactive oat beta-
l 3g of oat beta-glucan daily aids in glucan from our daily diet. Remember, a
lowering cholesterol healthy cholesterol level is the key to
l Oat soluble fibre (beta-glucan) helps achieving a heart-healthy lifestyle.
to decrease the rise of blood glucose,
provided that it is not consumed together This article is brought to you by Legosan
with other food (Malaysia) Sdn Bhd.
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info@biogrow.com.my
12 Obesity Awareness SUNDAY STAR, 18 OCTOBER 2020

Health risks of being overweight

OBESITY is currently a prevalent condition
among Malaysians. It is a multifactorial and Classifications of BMI
complex condition which is characterised by
excessive fat and leads to excess weight gain. Classification BMI
Generally, obesity is classified according to
the body mass index (BMI) and is calculated Underweight <18.5
as: BMI = Weight (kg) / Height (sq m).
There are also other ways to measure an Normal Weight 18.5 - 22.9
individual’s degree of overweight or obesity
such as the body fat percentage or waist Overweight >23
circumference (to measure abdominal fat
levels). Usually, a body fat percentage of
Pre-Obese 23 - 27.4
25% or more in males and 35% or more in Obese-1 27.5 - 34.9
females is considered as obese and requires
intervention to prevent other complications. Obese-2 35 - 39.9
A study carried out among the Malaysian
population by the National Institutes of Health Obese-3 >40
Malaysia showed 52.6% of adults suffered
abdominal obesity last year, higher than the The ideal weight loss should be about 0.5kg to 1kg a week over a six-month duration, says
48.6% in 2015, while obesity prevalence in Dr Imran.
adults rose from 17.7% (or 3.3 million people) Dr Imran Khan Jallaldeen.
in 2015 to 19.7% last year. The percentage of evaluate patients’ eating habits and lifestyles six-month duration. Losing a large amount
overweight individuals also increased slightly due to obesity, the quality of life of an obese that can be modified to reduce their weight. of weight over a shorter period is
from 30% in 2015 to 30.4% last year. This patient is hampered by his difficulty in With the available health screenings and considered dangerous to the patient’s
means that half of the adults in Malaysia are performing daily activities and the uptick evaluations, any underlying illnesses overall health and may cause rebound
either overweight or obese as of last year. in sedentary habits that will lead to more causing excessive weight gain such as weight gain once the individual deviates
Obesity by itself is a condition that needs weight gain and increased morbidity. hypothyroidism or metabolic syndromes from his weight loss routine (eating a very
to be addressed as it leads to various other One simple modification to lower a can be identified and quickly addressed. low number of calories during the weight
medical conditions and lifestyle implications. patient’s overall weight is by cutting down Such changes would undoubtedly cause loss phase, for example).
Some of the medical conditions indirectly his portion of daily intake which will most patients to experience a significant “It is vital to increase patients’ knowledge
caused by obesity are: indirectly reduce daily calorie intake and, amount of stress and demotivate them – regarding obesity and its complications, and
l Hypertension hence, create an overall calorie deficit. In therefore, it is suggested that they utilise provide awareness to others.”
l Type 2 diabetes mellitus addition, freshly prepared food with high some of the more common ways to manage He adds, “Obesity is a chronic condition
l High cholesterol fibre should be included in his diet. A calorie or cope with stress such as meditation, that will lead to various other medical
l Coronary heart disease, which leads to a deficit of 500 kilocalories (kcal) to 1,000kcal relaxation techniques and even physical conditions that could be detrimental to
heart attack from the patient’s total daily maintenance activity. Weight loss support groups will patients’ health and may reduce their
l Obstructive sleep apnoea calories is needed for weight loss. also help those with low self-confidence to overall quality of life. Hence, modifications
l Cardiac failure Moreover, it is recommended to drink six overcome this mindset, besides offering and interventions will be required to
l Fatty liver disease to eight glasses of water a day and make a more advice about sustainable methods for improve the quality of life and to prevent
l Gallstones habit of exercising in order to prevent weight loss. the development of conditions like
l Stroke obesity. Obese people can start exercising According to Dr Imran Khan Jallaldeen, hypertension, type 2 diabetes and so on.
l Osteoarthritis of the knees due to with a lower intensity during a shorter time MyHomeMedic Unit head at MSU Medical “In Malaysia, the adult obesity rate is
excessive weight period, then steadily and progressively Centre, “A reasonable weight loss goal increasing alarmingly and needs to be
l Certain cancer conditions increase the duration and intensity. must be set up and the ideal weight loss addressed by all parties to build a healthier
Besides developing into chronic illnesses Weight loss clinics provide counselling to should be about 0.5kg to 1kg a week over a and fitter nation overall.”

Grappling with body-shaming

> FROM PAGE 10

The weight of the stigma on people with

obesity becomes apparent in their mental
health. All stigmas are hurtful regardless of
their type, and people who are constantly
reminded that their obesity is something to
be ashamed of and reviled begin to
internalise it, believing that their condition
is indeed rightly attacked and hated.
Obese individuals constantly exposed to
the stigma commonly suffer from mental
health issues such as depression, feelings of
worthlessness, low self-esteem, poor body
image and suicidal thoughts. A report by
WHO indicates that such individuals often
redirect the body-shaming and stereotypes
onto themselves, joining others in the hatred
and dissatisfaction of their own bodies.
In an ironic twist, the weight stigma has
always had the opposite effect on people
with obesity when it comes to their
physical health and improving it. According
to a 2018 article published in Today’s
Dietitian titled The Health Impact of Weight
Stigma, the stigma has been intentionally
used in healthcare centres and in society Continuous stigma surrounding obesity can
as a “motivator” for obese people to lose negatively affect the mental health of
weight. However, those who have been individuals.
shamed by their healthcare providers or
have sensed the weight bias from their negative feelings by delving into self-
doctors are much more reluctant to return destructive behaviour such as binge eating
for their appointments, as they’ve lost trust and not exercising, which results in them
in their doctors or have been hurt by them. gaining even more weight than before.
Additionally, those with obesity often face Stigmas are never seen as good or helpful,
assumptions of bias from their healthcare regardless what form they may appear in.
providers, such as the belief that their health However, the stigma around weight has
issues can purely be solved by losing weight. been widely accepted by society – even by
This leads to inaccurate consultations and obese individuals themselves.
diagnoses, and obese patients are often left Instead of encouragement and support,
believing that their doctors won’t take them they’re faced with judgement and
seriously due to their weight. mockery, some done in the guise of
These factors combined create an “motivating” them to live a healthier
unpleasant cocktail of hurt, mistrust and low lifestyle. Would people want to live in a
self-worth for obese patients. They would society where obese individuals have
then cancel further appointments and often stopped believing in themselves because
avoid medical care altogether. Furthermore, no one said they could? Would you? Think
many people with obesity cope with their carefully about the answer.